Provider Demographics
NPI:1336769702
Name:PARR, BRANDON MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:MICHAEL
Last Name:PARR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 MARIE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-3200
Mailing Address - Country:US
Mailing Address - Phone:513-981-5463
Mailing Address - Fax:
Practice Address - Street 1:5525 MARIE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-3200
Practice Address - Country:US
Practice Address - Phone:513-981-5463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.075619207R00000X
OH34.016378207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine